Coagulating surgical instrument



Filed April l5, 1957 E S R H OfluwN MCI-.R s w N m, T., rznmA R W vm R QA HY B COAGULATIN G SURGICAL INSTRUMENT Harry Wright Seiger, Santa.Monica, Calif. Application April 15, 1957, Serial No. 652,896 2 Claims.(Cl. 12S-303.17)

This invention relates generally to surgical instruments and moreparticularly to an improved combination coagulating and suckinginstrument.

It is becoming common practice to stem bleeding yas a result of surgicaloperations or even natural causes by coagulating at the affected arearather ythan resorting to sutures, clamps, or tying oif of vessels. .Bycoagulation, no foreign body is introduced and there is .lessvdeformation of the tissues, which deformation usually occurs whensutures or clamps are used. Coagulation is best accomplished by alocalized controlled heating of the bleeding tissue area, `preferably bymeans ofhigh frequency electrical energy. The advantages of electricalenergy for providing the required degree of Aheat resides in the abilityof the operator to control the electrical energy level and to pinpointthe area to be treated.

One .of the more troublesome aspects of coagulating tissues is theblocking of visibility by tissue iluids, particularly blood and theresultant smoke and steam, rendering it `diicult to see the operatingarea clearly. It has been the practice in some instances, therefore, toemploy a suction tube while coagulating the tissues with con- Ventionaltype electrodes, in order to clear the area and maintain visibilityduring the coagulation procedure. Oftentimea'however, there .is notsuiiicient room without undue distorting of the tissues 'to provide.both a suction tube and a coagulating instrument, and further, itis notan easy matter to position :the suction tube such as to clear the areaof blood and :smoke `at the exact point at which it is desired tocoagulate the tissue.

Bearing the above in mind, .it is a primary object of the presentinvention to provide a vastly improved coagulating instrumentconstituting a -combined electrical "heating and suction means such thatthe operation of coagulating bleeding tissues may be effected-far moresimply than has been possible heretofore.

More particularly, it is an object to provide an improved surgicalinstrument employing a single common shaft for eifecting both suctionand coagulation whereby these combined functions may be effectedsimul-taneously without any increase in the actual size of thecoagulating instrument.

Still another object is to Vprovide an instrument of the above typewhich may be readily manually manipulated without interference from theelectrical energy vsource connected to the instrument for providing heatat its tip.

Another important object is to provide an instrument of the above typeemploying an improved coagulating tip portion which may be readilyremoved and replaced vfor cleaning purposes, and which is so designedthat the exact area to be coagulated is Ysimultaneously subject to thesuction feature whereby the tissue treated is at all times visible tothe operator notwithstanding emission of smoke, steam, blood and othertissue .fluids during the coagulating operation. v

These and other objects and advantages of the present invention areattained, briey, by providing a narrow elonnite States Patent .source ofsuction.

2,888,928 Patented June 2, 1959 gated hollow shaft terminating at oneend in Van open tip communicating with the hollow interior of the shaftand having its other end adapted to be connected to a Electrode meansare provided and connected to the exterior of the shaft at a pointintermediate to its ends. The portion of the shaft between the .tip andthe electrode means comprises an electrically conductive material sothat the shaft not only serves as a fluid conduit for the suctioningapparatus but also as an electrical conductor for passing high frequencyelectrical energy from the electrode to the tip of the instrument.

The tip itself comprises a conically shaped member having an axialopening at its apex and a threaded base adapted to be received on theshaft whereby it is `readily removable for cleaning. Preferably, theapex portion of the conically shaped tip is quite small so that theheating effect of the high frequency electrical energy ,is concentrated,essentially in a very small area, to facilitate coagulation of only thedesired area. lIn order to `insure eifective suctioning, however, thetip is also provided With a series of lateral openings through itsconical surface adjacent the apex so that fluids may pass through theselateral openings as well as the end axial opening to insure completedrainage during the operation. The handle of the instrument is suita'blyinsulated and there is also provided an insulated sleeve about the shaftportion between the electrode and the tip such that the high frequencyelectrical energy cannot be dissipated to ground except at the `tipportion of the instrument where its effects are desired.

A vbetter understanding of the invention will be had by referring to apreferred embodiment thereof as illustrated in the accompanyingdrawings, in which: v

Figure 1 is a perspective View of the entire instrument of thisinvention;

Figure 2 is an enlarged perspective Vexploded view of the electrodeportion of the instrument enclosed within the circular arrow 2 of Figure1;

Figure 3 is an enlarged cross section illustrating the connection of aportion of the electrode to the instrument shaft; and,

Figure 4 is an enlarged cross section of the tip portion of theinstrument.

Referring to Figure 1, the instrument comprises a hollow handle 10vsecured to a shaft portion 11 terminating at one end ina tip 12.Intermediate the ends of the instrument there is provided an electrodemeans 13 adapted to connect a source of high frequency electrical energyfrom a wire W to the shaft which n turn serves to conduct this energy tothe tip 12. The far end of the handle 10 terminates in a nipplestructure 14 adapted to be connected to a suction apparatus.

Referring to Figure 2, the electrode means 13 is illustrated in greaterdetail and as shown, comprises a cylindrical element 15 provided with anaxial opening 16 at its upper end adapted to threadedly receive a screw17 for securing a wire or the like within a socket 18 from a source ofhigh frequency electrical energy. The lower end portion of the element15 is in turn provided with a transverse bore 19 diametrically passingthrough the element 15. The dimensioning of the bore 19 is such as toreceive the conducting portion of the shaft. As shown in Figure 2, thebore 16 in the cylindrical element 15 includes a biasing spring 2.0adapted to bear against the top of the shaft when the shaft ispositioned in the transverse bore 19. By adjusting the inward extent ofscrew 17, the biasing pressure of spring 20 may be adjusted.

The connection of the electrode to the shaft will be better understoodby referring to Figure 3 wherein the shaft 11 is .illustrated ascomprising a metallic .tubular conducting material 21 provided `with aninsulating sleeve 22 terminating at one end adjacent the cylindricalelement 15. As shown, the tubular shaft 21 passes through the transversebore 19 terminating in threads 23 at its protruding end. The threads 23are adapted to be threadedly coupled to interior threads in the hollowhandle 10. As indicated by the drawing, the handle is made of aninsulative material and includes a hollow passage 24 communicating withthe end opening nipple portion 14 of Figure l for connection to asuction machine. The portion of the metallic shaft 21 between theinsulated sleeve 22 and handle 10 is exposed to make direct electricalcontact with the sides of the transverse bore 19 of the cylindricalelement 15. It will be clear from Figure 3, that the biasing spring 20within the bore opening 16 is biased into contact with the outer surfaceof this portion of the shaft tube 21 so that a positive electricalconnection between t-he element and tube is always maintained. Further,it will be evident that the element 15 is free to revolve about the tube21 as an axis so that any wire such as the wire W of Figure 1 connectedto the upper end of the cylindrical electrode element 15 will not tendto be Wrapped about the instrument should the instrument be axiallyrotated during an operation.

Referring now to Figure 4, it will be noted that the insulated sleeve 22terminates just short of the extreme tip portion of the tip 12. The endportion of the tube 21 is bent as at 25 and is provided with suitableexterior threads 26 for receiving the tip 12. The tip 12 itself isgenerally of a conical shape having interior threads about its base forconnection to the threads 26. Alternatively, the threads may be reversedso that the interior end of the tube 21 is threaded and the exterior ofthe tip 12 threaded without change in function. It will be evident thatby unthreading the threaded connection at 26, the tip 12 may be readilyremoved for cleaning or for replacement by another tip of diiferentdimensions depending upon the particular operation for -which theinstrument is to be used.

The tip 12 terminates at its apex in an axial opening 27. Necessarily,this opening 27 is small in order to enable the operator to concentratethe heating area as a result of the high frequency energy passed throughthe tubular shaft 21 and tip 12. Therefore, the tip 12 is also providedwith a series of lateral openings 23 through its conical surfaceadjacent the apex to provide la greater ingress area for tissue fluidssuch as blood to increase the efficacy of the sucking operation.

To facilitate the unthreading of the tip 12, the portion of theinsulating sleeve 22 covering the conical tip up to the opening 28 mayrst be slid back lalong the tube; alternatively, this insulative sleevemay be terminated adjacent the threaded portion 26 as at 29 and aseparate insulated sleeve provided for the upper portion of the conicaltip. This separate sleeve may be permanently aflixed to the tip andextend from the point 29 up to the openings 28 whereby the tip with itsaiiixed insulation may be readily removed for easy cleaning.

The overall operation of the instrument will be evident from the abovedescription. In effecting a coagulation of a local tissue area, asuitable source of high frequency electrical energy is connected to theelectrode 13 and this electrical energy is conducted by the metallicshaft tube 21 to the tip 12. A suction source is also connected to thefar end of the handle as at 14 whereby suction through the hollowinterior of the shaft 11 and handle 10l is continuously maintained. Intreating the affected area, the high frequency electrical energy will beconcentrated at the tip adjacent the tip opening 27 Where it will`ground to the tissues. As a result of the resistance to this electricalflow between the contact of the tip of the conically shaped portion 12with the tissue, suicient heat will be generated to coagulate thetissue. Because of the relatively small area of the metallic portionexposed adjacent the tip opening 27, the area coagulated may be veryprecisely controlled. Further, as a result of the continuous suction,the uids and smoke in the immediate area will be drawn through the axialopening 27 and 1latenal openings 28 up through the conical tip portions12 and shaft and subsequently through the handle 10.

By employing only a single tubular arrangement such as comprised of theconically shaped tip 12 and shaft 21 for both conducting the highfrequency electrical energy to the area to be treated and for carryingaway tissue fluids and smoke in such area, not only is the particulararea being treated always rendered visible as a result of the removal ofthe iluid and smoke at the exact point of operation, but the overallsize of the instrument is not unduly increased and precise areas may betreated without undue distortion of adjacent tissues or organs. Further,by providing the bend at 25 whereby the axis of the cone is inclinedwith respect to the axis of the shaft, the point being treated by theextreme end of the tip 12 is not obscured from view by the remaining.portions of the shaft. In the event the tip 12 should become clogged,it may be readily removed and suitably cleaned and then replaced.Alternatively, and as mentioned heretofore, different shaped tips may besubstituted for the tip 12 depending upon the particular operation beingperformed.

Finally, any axial rotation of the instrument during an operation willnot tangle the wire leading to the electrode 13 inasmuch as the shaftmay rotate within the electrode and the electrode maintain a relativelyconstant position.

The present invention thus provides a greatly improved `combinationcoagulating and suction instrument employ- Aing a minimum number ofparts wherein a single elongated tubular means provides the dualfunction of providing a suction vpassage and conducting high frequencyelectrical energy to the immediate area to be treated. Variousmodifications `falling within the scope and spirit of thepresentinvention, however, will occur to those skilled in the art. Thecoagulating instrument of this invention is, therefore, not to bethought of as limited to the specific embodiment set forth 4forillustrative purposes. i

What is claimed is:

l. A surgical instrument comprising: a hollow shaft having one endterminating in an open tip communicating with the hollow interior ofsaid shaft and its other end adapted to be connected to a source ofsuction; an electrode means including a cylindrical element having athreaded axial opening in one end and a threaded screw receivable insaid opening for securing a wire to said cylindrical element, saidcylindrical element having a transverse diametric bore adjacent itsother end for receiving said shaft; and spring biasing means withinsaid-cylindrical element biasing said shaft against the inner walls ofsaid transverse bore so that said cylindrical element is -free torevolve about the axis of said shaft while continuously maintainingelectrical contact with' said shaft, the portion of said shaft betweensaid tip and said cylindrical element comprising electrically conductivematerial whereby high frequency electrical energy may be passed fromsaid electrode means to said tip.

A surgical instrument comprising, in combination: a hollow electricallyconductive shaft having one end terminating in a threaded opening; ahollow electrically conductive tip member having a tapered exterior, thelarger end thereof being threadedly engageable with said threadedopening, and the smaller end thereof terminating in at least one openingadjacent its apex communicating through the hollow interior of said tipmember with the interior of said shaft, the other end of said shaftterminating in a nipple portion for connection to a source of suction;an electrode means including a cylindrical element having a threadedaxial opening in one end and a threaded screw receivable in said openingfor securing a Wire to said cylindrical element, said cylindricalelement having a transverse diametrc bore adjacent its other end forreceiving said shaft; spring biasing means within said cylindricalelement biasing said shaft against the inner walls of said transversebore so that said cylindrical element is free to revolve about the axisof said shaft while continuously maintaining electrical contact withsaid shaft so that high frequency electrical energy may be passed fromsaid elect-rode means to the tip portion of said tip member; and aninsulating sleeve surrounding said shaft between said electrode and saidopening adjacent said apex of said tip member, whereby said energy isconcentrated at said tip portion of said 6 tip member to coagulatetissue, tissue iluids being sucked through said opening to pass throughsaid shaft, said threaded engagement enabling manual removal of said tipmember for cleaning and replacement during and 5 between operations.

References Cited in the le of this patent UNITED STATES PATENTS DinyerFeb. 11, 1936 2,808,833 August Oct. 8, 1957

